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What the FDA labels say about taking them together

Methotrexate and tetracycline

Methotrexate's FDA label (Rasuvo) of December 15, 2025 names tetracycline in its drug interactions section; the tetracycline label PlainMeds reads does not name methotrexate. The methotrexate label: “Oral antibiotics such as tetracycline, chloramphenicol, and nonabsorbable broad spectrum antibiotics, may decrease intestinal absorption of methotrexate or interfere with the enterohepatic circulation by inhibiting …”

Check it at the source: the methotrexate FDA label on DailyMed (effective May 27, 2026, Accord Healthcare Inc.); the tetracycline FDA label on DailyMed (effective March 18, 2025, Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.).

What does the methotrexate label say about tetracycline?

Rasuvo label (Medexus Pharma Inc., December 15, 2025), drug interactions

Oral antibiotics such as tetracycline, chloramphenicol, and nonabsorbable broad spectrum antibiotics, may decrease intestinal absorption of methotrexate or interfere with the enterohepatic circulation by inhibiting bowel flora and suppressing metabolism of the drug by bacteria.

Source: FDA drug label (Rasuvo, NDA205776), Medexus Pharma Inc., effective December 15, 2025 (SPL set d0075461-0e7e-4967-9c9b-d6440e912c0e), via openFDA

Source: FDA drug label (Methotrexate), Accord Healthcare Inc., effective May 27, 2026 (SPL set 874c7f43-a3be-4236-89cc-24c44e3c5813), via openFDA; the full label on DailyMed

What does the tetracycline label say about methotrexate?

Tetracycline's label (effective March 18, 2025) does not name methotrexate in these sections. A label lists what its studies and reports found; it is not a complete list.

Source: FDA drug label (tetracycline hydrochloride), Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc., effective March 18, 2025 (SPL set eaa5b1bd-0927-46e4-b941-32fcc492d258), via openFDA; the full label on DailyMed

These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.

Both medicines on the record

29Methotrexate generic labelers
10Tetracycline generic labelers
MethotrexateTetracycline
Labeled forRheumatoid arthritis, Psoriasis, Leukemia, lymphoma and myeloma, Breast cancerBacterial infections
Boxed warningYesNo
Pharmacy cost (NADAC)$0.158 per tablet 2.5 mg tablet$0.247 per capsule 250 mg capsule
Shortage nowIn shortageNo current entry

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

What next?